Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mr. Tanner James Vick, PA-C

Individual provider Medical Physician Assistant · NPI 1487632667

Mr. Tanner James Vick, PA-C is a Physician Assistant in Everett, Washington. Qualified in 2004, 22 years ago. Practices with Providence Health and Services- Washington, a 526-clinician group and accepts Medicare assignment. Licensed in Washington.

Years since qualifying
22
Licensed in
WA
In the registry since
2006
Specialties on file
2
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

1330 Rockefeller Ave Ste 520
Everett, WA 98201-1684
Phone: (425) 297-5200
Fax: (425) 297-5210
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X · Licence PA10004747 (WA)
Medical Physician Assistant Taxonomy 363AM0700X · Licence PA10004747 (WA)

Record details

NPI number1487632667
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJanuary 6, 2006
Last updated in NPPESApril 28, 2021
Certification dateApril 28, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2004 (22 years in practice)
Group practice Providence Health And Services- Washington — 526 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations5 on file with Medicare

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